<form id="editModal" method="post" action="__ACTION__" data-validate="true" data-submit="ajax" class="form-horizontal">
	<div class="modal hide fade" tabindex="-1" role="dialog" aria-hidden="true">
	  <div class="modal-header">
	    <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
	    <h3 id="myModalLabel">加入黑名单</h3>
	  </div>
	  <div class="modal-body">
	  	<input type="hidden" name="ids" value="{$ids}">
		<div class="control-group">
			<label class="control-label">解封时间</label>
			<div class="controls">
				<div data-toggle="date" class="input-append date" data-format="yyyy-MM-dd HH:mm:ss">
	                <input type="text" name="end_time" readonly="readonly"/> 
					<span class="add-on"><i class="icon-calendar"></i></span>
				</div>
			</div>
		</div>
		<div class="control-group">
			<label class="control-label">备注</label>
			<div class="controls">
				<textarea class="leave_message" name="remark" placeholder="最多输入255字" maxlength="255" style="margin: 0px; width: 236px; height: 61px;"></textarea>
			</div>
		</div>
	  </div>
	  <div class="modal-footer">
	    <button class="btn" data-dismiss="modal" aria-hidden="true">关闭</button>
	    <button class="btn btn-primary">保存</button>
	  </div>
	</div>
</form>